| NPI | 1588864706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1789) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2007018533) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2020-01-06 |